Could You Have Lactose Intolerance?

After eating your favorite cereal and milk for breakfast, you feel bloated and have stomach cramps. Then, the diarrhea starts. What causes these embarrassing symptoms?

If you suffer from gas, cramps, bloating, nausea, or diarrhea after you eat dairy foods, you may be one of the millions of Americans who have lactose intolerance. 

Lactose intolerance is an uncomfortable and often embarrassing condition that occurs when your body cannot digest lactose, a sugar found in dairy products. The small intestine produces an enzyme called lactase that breaks down lactose and helps your body absorb it. If your body doesn’t produce enough lactase, you may experience the symptoms of lactose intolerance.

Lactose Intolerance Symptoms

The symptoms of lactose intolerance include:

• Cramps
• Bloating
• Gas
• Diarrhea
• Nausea

Symptoms may be mild or severe. Although there is no cure for lactose intolerance, there are many things you can do to feel better. Your doctor may ask you to keep a diary of the foods you eat and to note when you experience symptoms.

Is It Lactose Intolerance?

Other conditions such as irritable bowel syndrome may cause symptoms similar to lactose intolerance. These conditions, however, may not require you to limit your dairy intake as much.

Your doctor may perform medical tests to help diagnose lactose intolerance. These tests may include: 

• Hydrogen Breath Test. Normally you have very little hydrogen in your breath. But if your body does not digest lactose, then levels of hydrogen will build up in your intestines and will eventually pass out of your body through your breath. During this test, you’ll drink a beverage containing lactose. Then your breath will be analyzed over time for hydrogen content.
• Lactose Tolerance Test. This blood test measures the amount of glucose in your blood. After you have fasted, a blood sample is taken, and then you drink a liquid that is high in lactose. After two hours, more blood is drawn. Lactose causes glucose blood levels to rise. If glucose levels in the second sample are not higher, you have not digested the lactose.
• Stool Acidity Test. This test is used to diagnose lactose intolerance in children. A stool sample is collected after an infant or child drinks liquid containing lactose. If lactose is not digested, it forms lactic acid and other acids. The acidity of the stool is measured.

It’s Lactose Intolerance. What Now?

There is no cure for lactose intolerance, but you can reduce or even eliminate lactose intolerance symptoms by limiting the dairy products you eat. For many people, it is not necessary to get rid of dairy completely. You may be able to eat dairy foods in small quantities.

Effective lactose intolerance treatment involves talking to your doctor or a registered dietitian to help plan a healthy diet that keeps you feeling good. A food diary may help you determine how much, if any, dairy you can eat without experiencing lactose intolerance symptoms.

For many people, treatments may help prevent lactose intolerance symptoms. These products include:

• Lactase enzyme replacement tablets or caplets. Taking these with your first drink or bite of dairy may help prevent lactose intolerance symptoms.
• Lactose-free or reduced-lactose milk and dairy products. Many manufacturers now offer dairy products that have had most of the lactose removed or lactase added to the products.
• Dairy-free products. There are many alternatives to dairy, such as soy or rice milk.

Not Just Dairy

Many foods contain hidden lactose. If you are extremely sensitive to lactose, you may need to avoid products such as: 

• Instant foods (breakfast drink mixes, mashed potatoes, soups, and meal replacement drinks)
• Bread, baking, and pancake mixes
• Baked goods
• Breakfast cereals
• Nondairy creamers (liquid and powdered)
• Nondairy whipped topping
• Salad dressing
• Margarine
• Protein and meal replacement bars
• Processed meats (bacon, hot dogs, sausage, and lunch meats)
• Candy

To help prevent lactose intolerance symptoms, read food product labels carefully. When shopping or cooking, look for these lactose-containing ingredients: 

• Milk
• Dry milk solids
• Nonfat dry milk powder
• Milk byproducts
• Lactose
• Whey
• Curds

What About Calcium?

If you suffer from lactose intolerance, don’t let it prevent you from getting enough calcium in your diet. Calcium is an essential nutrient and is important for healthy teeth and bones.

According to the National Institutes of Health, most people who are lactose intolerant can tolerate as much as 12 grams of lactose or as much as 1 cup of milk without serious symptoms -- especially when consumed with other food. 

Although dairy products are a major source of calcium, there are many other foods that contain calcium. Fruits and vegetables that contain calcium include:

• Green, leafy vegetables (kale, collard greens)
• Non-dairy beverages, such as soy, rice, and almond milk
• Broccoli
• Beans
• Nuts (almonds, hazel nuts, pecans, walnuts)

Other dairy-free or low-lactose foods that are high in calcium include: 

• Canned fish with edible bones (sardines and salmon)
• Plain, low-fat yogurt
• Reduced-lactose milk
• Ice cream
• Cottage cheese
• Hard cheese (like Swiss)

Lactose intolerance can be uncomfortable, but it is manageable. With a little attention to your diet, you can prevent the pain and discomfort of lactose intolerance and ensure that your bones and body stay healthy.